Saturday, October 29, 2016

From Dara Aisner and colleagues: Maximizing Small Biopsy and Cytology Specimens for Molecular and Ancillary Testing

Dara L. Aisner MD, PhDMathew D. Rumery MDDaniel T. Merrick MDKimi L. Kondo DOHala Nijmeh PhDDerek J. Linderman MDRobert C. Doebele MD, PhDNatalie Thomas MPhilPatrick C. Chesnut BAMarileila Varella-Garcia PhDWilbur A. Franklin MDD. Ross Camidge MD, PhD
From the Departments of Pathology (Drs Aisner, Rumery, Merrick, Nijmeh, and Franklin, Ms Thomas, and Mr Chesnut), Radiology (Dr Kondo), and Medicine (Drs Linderman, Doebele, Varella-Garcia, and Camidge), University of Colorado, Aurora. Dr Rumery is now with Colorado Pathology Consultants, Denver.
Reprints: Dara L. Aisner, MD, PhD, Department of Pathology, University of Colorado, Mail Stop F768, 12605 E 16th Ave, Aurora, CO 80045 (email: ).
This work was supported in part by the Molecular Pathology Shared Resource and the Tissue Biobanking and Processing Shared Resource of Colorado's NIH/NCI Cancer Center Support Grant P30CA046934. Drs Aisner and Franklin disclose partial ownership of patent number PCT/US13/38284, describing a pneumatic cell collection device that can be used for microdissection. This device was not used for any of the microdissections presented in this manuscript. Dr Merrick received honoraria for preceptorship (March 2016) from ARIAD Pharmaceuticals Inc, Cambridge, Massachusetts. The other authors have no relevant financial interest in the products or companies described in this article.
Context.— In an era in which testing of patient tumor material for molecular and other ancillary studies is of increasing clinical importance for selection of therapy, the ability to test on small samplings becomes critical. Often, small samplings are rapidly depleted in the diagnostic workup or are insufficient for multiple ancillary testing approaches.
Objective.— To describe technical methodologies that can be implemented to preserve and maximize tissue for molecular and other ancillary testing.
Data Sources.— Retrospective analysis of a case cohort from the University of Colorado, description of techniques used at the University of Colorado, and published literature.
Conclusions.— Numerous techniques can be deployed to maximize molecular and other ancillary testing, even when specimens are from small samplings. A dedicated process for molecular prioritization has a high success rate, but also increases workload, which must be factored into establishing such a process. Additionally, establishing high-fidelity communication strings is critical for success of dedicated molecular prioritization of samples. Numerous approaches can be deployed for alternative specimen types, and several technical approaches can also aid in maximizing small specimens.

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